American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 283.e1-283.e8, March 2008

Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial

  • Leila Katz, MD, PhD

      Affiliations

    • Departments of Obstetrics and Gynecology, Professor Fernando Figueira Institute for Maternal and Child Health Care, Recife, Pernambuco, Brazil
    • Corresponding Author InformationReprints: Dr. Leila Katz, Departments of Obstetrics and Gynecology, Professor Fernando Figueiroa Institute for Maternal and Child Health Care, Recife, Pernambuco, Rua Frei Matias Teves, No. 280, sala 418, Ilha do Leite, Recife-PE, Brazil.
    • ,
  • Melania Maria Ramos de Amorim, MD, PhD

      Affiliations

    • Departments of Obstetrics and Gynecology, Professor Fernando Figueira Institute for Maternal and Child Health Care, Recife, Pernambuco, Brazil
    • University of Campina Grande School of Medicine, Campina Grande, Paraíba, Brazil
    • ,
  • José Natal Figueiroa, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, Professor Fernando Figueira Institute for Maternal and Child Health Care, Recife, Pernambuco, Brazil
    • ,
  • João Luiz Pinto e Silva, MD, PhD

      Affiliations

    • Universidade Estadual de Campinas School of Medicine, Campinas, São Paulo, Brazil.

Received 5 June 2007; received in revised form 17 August 2007; accepted 11 October 2007. published online 21 January 2008.

Objective

The purpose of this study was to determine the effectiveness of postpartum dexamethasone in patients with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.

Study Design

A prospective, randomized, double-blind trial was conducted in which 105 women with HELLP syndrome were enrolled and assigned randomly to treatment or placebo groups following delivery. Duration of hospital stay, maternal morbidity, and laboratory and clinical parameters were evaluated.

Results

There was no difference in maternal morbidity or mortality between the 2 groups. There was also no difference in duration of hospitalization and the need for rescue scheme or the use of blood products between groups. Linear model adjustments showed no significant difference between groups with respect to the pattern of platelet count recovery, aspartate aminotransferase, lactate dehydrogenase, hemoglobin, or diuresis.

Conclusion

These findings do not support the use of dexamethasone in the puerperium for recovery of patients with HELLP syndrome.

Key words: dexamethasone, hemolysis, elevated liver enzymes, and low platelets syndrome, postpartum, randomized controlled trial

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 Cite this article as: Katz L, de Amorim MMR, Figueiroa JN, et al. Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol 2008;198:283.e1-283.e8.

PII: S0002-9378(07)02019-4

doi:10.1016/j.ajog.2007.10.797

American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 283.e1-283.e8, March 2008

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